NPI | 1770517740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: FL opc 3216) |
Additional Taxonomies | 152W00000X Optometrist (Licence: FL opc3216) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2020-11-12 |