NPI | 1861986358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.006934) |
Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2773) |
Enumeration Date | 2018-06-18 |
Last Update Date | 2022-08-31 |