NPI | 1447287677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MN 1811) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: ND 531) |
Enumeration Date | 2006-06-26 |
Last Update Date | 2018-01-12 |