| NPI | 1891837852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: CA 6656T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 6656) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-02-12 |