NPI | 1801977889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00437700) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OM00075900) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2014-07-18 |