| NPI | 1124149992 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003263A) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: IN 18003263A) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2023-11-11 |