NPI | 1558567354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 935) |
Additional Taxonomies | 152W00000X Optometrist (Licence: UT 6640313-9934) |
Enumeration Date | 2007-06-27 |
Last Update Date | 2018-03-17 |