| NPI | 1689432064 |
|---|---|
| Other Name | JACK BAUMER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.007265) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2025-11-24 |