NPI | 1710985866 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NH 0799G) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA03548) |
Enumeration Date | 2005-07-12 |
Last Update Date | 2010-01-19 |