NPI | 1841421815 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: LA 1774-708T) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7394T) |
Enumeration Date | 2009-08-07 |
Last Update Date | 2023-03-28 |