NPI | 1528797511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3778) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901005619) |
Enumeration Date | 2022-06-06 |
Last Update Date | 2023-06-13 |