NPI | 1710935606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1053) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NC 1053) |
Enumeration Date | 2006-05-04 |
Last Update Date | 2018-03-17 |