NPI | 1588977482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NY 007610) |
Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: NY 007610) |
152WP0200X Optometrist Pediatrics (Licence: NY 007610) | |
152WS0006X Optometrist Sports Vision (Licence: NY 007610) | |
152WV0400X Optometrist Vision Therapy (Licence: NY 007610) | |
Enumeration Date | 2010-07-20 |
Last Update Date | 2021-06-11 |