NPI | 1437170016 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00589300) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV-006709) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2022-07-21 |