| NPI | 1417909904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: OH 3068/T-1624) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: PA OE-004881P) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-03-18 |