NPI | 1720838873 |
---|---|
Other Name | WALT WILLIAMS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004506A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2024-03-22 |
Last Update Date | 2024-06-12 |