NPI | 1538121355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ Ma53350) |
Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NJ MA53350) |
Enumeration Date | 2006-04-05 |
Last Update Date | 2007-07-08 |