NPI | 1881689610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27 OA 00289000) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27 OM 00012400) |
152WC0802X Optometrist Corneal and Contact Management (Licence: NJ 27 OA 00289000) | |
152WL0500X Optometrist Low Vision Rehabilitation (Licence: NJ 27 OA 00289000) | |
152WP0200X Optometrist Pediatrics (Licence: NJ 27 OA 00289000) | |
Enumeration Date | 2005-09-19 |
Last Update Date | 2018-11-20 |