NPI | 1467648881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 06876TG) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 06876TG) |
152WX0102X Optometrist, Occupational Vision (Licence: TX 06876TG) | |
Enumeration Date | 2007-09-19 |
Last Update Date | 2023-09-11 |