NPI | 1952307084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC2214) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA0943) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2023-10-26 |