NPI | 1871617787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1132-3) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: KS 1132-3) |
152WP0200X Optometrist, Pediatrics (Licence: KS 1132-3) | |
Enumeration Date | 2007-03-17 |
Last Update Date | 2017-05-11 |