| NPI | 1861425662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 11977T) |
| Additional Taxonomies | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 11977T) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2023-03-07 |