NPI | 1497889711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: OH 5444) |
Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1606DT) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2013-06-04 |