NPI | 1578781134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OP9289T) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA OP9289T) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2011-07-08 |