NPI | 1629418728 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 793) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NV 793) |
Enumeration Date | 2013-07-03 |
Last Update Date | 2024-01-03 |