| NPI | 1730229345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA OPT9603) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: HI HI309) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2025-09-02 |