| NPI | 1770740532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NE 1248) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CO 1839) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: NV 568) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: IA 2423) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: AZ 2012) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: IL 046.010743) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: KS 1993) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2016-01-07 |