| NPI | 1437153129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH 3146T157) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: OH 3146T157) |
| 152WP0200X Optometrist Pediatrics (Licence: OH 3146T157) | |
| 152WX0102X Optometrist Occupational Vision (Licence: OH 3146T157) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2014-10-09 |