NPI | 1760672331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR 4014) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2527) |
Enumeration Date | 2007-07-30 |
Last Update Date | 2024-07-02 |