NPI | 1568482271 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1635) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NC 1635) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2024-03-26 |