| NPI | 1992768709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NC 26839) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 26839) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2014-03-06 |