NPI | 1720077076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NH 922) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0618001016) |
Enumeration Date | 2005-10-19 |
Last Update Date | 2017-02-19 |