NPI | 1477525608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OP6214T) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA MF0730970) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2011-01-17 |