NPI | 1669475182 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 2288TG) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TX 2288TG) |
Enumeration Date | 2005-05-30 |
Last Update Date | 2016-08-30 |