NPI | 1740355734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CO 1415) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CO 1415) |
152WP0200X Optometrist, Pediatrics (Licence: CO 1415) | |
152WS0006X Optometrist, Sports Vision (Licence: CO 1415) | |
152WX0102X Optometrist, Occupational Vision (Licence: CO 1415) | |
Enumeration Date | 2006-11-22 |
Last Update Date | 2007-07-09 |