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 |