NPI | 1952894487 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT33883-TLG) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA OPT33883-TLG) |
Enumeration Date | 2018-06-09 |
Last Update Date | 2019-10-18 |