NPI | 1457436537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 2113) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 152w00000x) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2023-10-26 |