NPI | 1386807899 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4511) |
Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002468) |
Enumeration Date | 2008-07-03 |
Last Update Date | 2022-11-14 |