| NPI | 1447245188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT7226TLG) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: CA OPT7226TLG) |
| 152WC0802X Optometrist Corneal and Contact Management (Licence: CA OPT7226T) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2007-07-08 |