NPI | 1770566556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002449) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046-008335) |
Enumeration Date | 2005-11-25 |
Last Update Date | 2010-09-02 |