Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2921-035 | WI |
NPI | 1003979923 |
---|---|
Provider Name | Christopher Salfai |
First Address | San Antonio, TX 78213-1370 |
Second Address | Eau Claire, WI 54701-8914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
38621900 | (05) | WI |
U98250 | (02) | WI |