NPI | 1801902606 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: TX 1892) |
Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: TX 1892) |
152WP0200X Optometrist Pediatrics (Licence: TX 1892) | |
152WS0006X Optometrist Sports Vision (Licence: TX 1892) | |
152WV0400X Optometrist Vision Therapy (Licence: TX 1892) | |
Enumeration Date | 2006-08-22 |
Last Update Date | 2007-07-09 |