| NPI | 1538215777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TN 2419) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CO 1786) |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2012-09-19 |