| NPI | 1447956180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV009720) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY 009720) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY TUV009720) | |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2025-03-13 |