| NPI | 1518348432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 15354 TLG) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: NY TUV008277) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2022-01-03 |