NPI | 1861621864 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: UT 7383319-9934) |
Additional Taxonomies | 152WS0006X Optometrist, Sports Vision (Licence: UT 7383319-9934) |
152WP0200X Optometrist, Pediatrics (Licence: UT 7383319-9934) | |
152WV0400X Optometrist, Vision Therapy (Licence: UT 7383319-9934) | |
Enumeration Date | 2009-07-10 |
Last Update Date | 2020-06-02 |