NPI | 1871682617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: OH OH3369) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH OH3369/T619) |
152WC0802X Optometrist, Corneal and Contact Management (Licence: OH OH3369/T619) | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2012-02-13 |