| NPI | 1750464624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 8126T) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 8162T) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-11-29 |