| NPI | 1508966805 |
|---|---|
| Other Name | TOM DETERMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ OD 786) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: AZ OD 786) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-01-12 |