| NPI | 1740287853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: TN 749) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN 749) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2014-10-22 |