NPI | 1831377217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 13067T) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NV 571) |
Enumeration Date | 2008-02-07 |
Last Update Date | 2010-07-15 |