NPI | 1457313363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2005-00746) |
Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: NC 2005-00746) |
Enumeration Date | 2006-04-05 |
Last Update Date | 2022-05-24 |