Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901002311 | MI |
NPI | 1013033869 |
---|---|
Provider Name | David S Klar |
First Address | Highland, MI 48356-2810 |
Second Address | Highland, MI 48356-2810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 19/11/2013 |