NPI | 1457723355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC 5156) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: FL OPC 5156) |
Enumeration Date | 2015-10-30 |
Last Update Date | 2015-10-30 |