NPI | 1851330179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 10451T) |
Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3179) |
152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 10451T) | |
152WC0802X Optometrist, Corneal and Contact Management (Licence: WA 3179) | |
Enumeration Date | 2006-06-05 |
Last Update Date | 2007-07-08 |