NPI | 1386620789 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NH 552) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VT 0300000272) |
Enumeration Date | 2005-12-16 |
Last Update Date | 2024-01-23 |