NPI | 1821657198 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.006800) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH 6800) |
Enumeration Date | 2019-06-11 |
Last Update Date | 2021-04-26 |