NPI | 1447321146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CT 000890) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CT 000890) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2012-07-30 |