NPI | 1821180894 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 3492) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MA 3492) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2011-03-02 |