NPI | 1922668102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 1054) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA 34275TLG) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-06-19 |
Last Update Date | 2020-10-06 |