NPI | 1407827199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NJ 00095) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 4774) |
Enumeration Date | 2006-01-30 |
Last Update Date | 2012-03-27 |