NPI | 1427057868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1022) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NC 1022) |
152WP0200X Optometrist, Pediatrics (Licence: NC 1022) | |
152WL0500X Optometrist, Low Vision Rehabilitation (Licence: NC 1022) | |
Enumeration Date | 2005-07-19 |
Last Update Date | 2013-12-03 |