| NPI | 1851338933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY TUV006869) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: AL S-971-TA-533) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2016-12-12 |