| NPI | 1831275916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 7926T) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 7926T) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2021-11-30 |