NPI | 1518941269 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: MD TA732) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA732) |
Enumeration Date | 2005-12-05 |
Last Update Date | 2012-05-16 |