| NPI | 1548233364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NJ 27oa003420) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY 56-0003208) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2011-01-20 |