NPI | 1487668208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: OK 1138) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CO 1333) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2010-06-14 |