NPI | 1699763458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 46-9636) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IL 46-9636) |
152WP0200X Optometrist, Pediatrics (Licence: IL 46-9636) | |
152WS0006X Optometrist, Sports Vision (Licence: IL 46-9636) | |
152WX0102X Optometrist, Occupational Vision (Licence: IL 46-9636) | |
Enumeration Date | 2005-10-06 |
Last Update Date | 2010-11-10 |