NPI | 1740700913 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NH 1052) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VT 030.0131034) |
Enumeration Date | 2017-06-20 |
Last Update Date | 2022-03-11 |