NPI | 1538169784 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTA-00491) |
Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: RI ODTA-00491) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2013-04-16 |