| NPI | 1477588614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: SC 2036) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: KY 1632DT) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-08-27 |