NPI | 1497286496 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33628) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60707338) |
Enumeration Date | 2017-03-22 |
Last Update Date | 2017-03-22 |