NPI | 1386791630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 697) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL IL046008712) |
Enumeration Date | 2007-01-05 |
Last Update Date | 2012-09-19 |