NPI | 1427459486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15410) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NC 2379) |
Enumeration Date | 2014-09-09 |
Last Update Date | 2016-11-04 |