NPI | 1861413304 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA 8132T) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 8132T) |
152WP0200X Optometrist, Pediatrics (Licence: CA 8132T) | |
152WS0006X Optometrist, Sports Vision (Licence: CA 8132T) | |
152WX0102X Optometrist, Occupational Vision (Licence: CA 8132T) | |
Enumeration Date | 2006-07-21 |
Last Update Date | 2009-10-15 |