NPI | 1891736146 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: KS 1124-3) |
Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: KS 1124-3) |
152WL0500X Optometrist Low Vision Rehabilitation (Licence: KS 1124-3) | |
152WX0102X Optometrist Occupational Vision (Licence: KS 1124-3) | |
Enumeration Date | 2006-06-09 |
Last Update Date | 2007-07-11 |