NPI | 1376983874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC5023) |
Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: FL OPC5023) |
Enumeration Date | 2013-06-28 |
Last Update Date | 2017-08-07 |