| NPI | 1427043884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: TX 3701-TG) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: OK 1144) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2016-06-29 |