| NPI | 1205938271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18002264) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 8807) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2021-10-25 |