NPI | 1982714564 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MO T02542) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MO t02542) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2019-02-27 |