NPI | 1023196755 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001863) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001863B) |
Enumeration Date | 2006-11-01 |
Last Update Date | 2007-07-08 |