| NPI | 1235341058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: IN 18002177A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002177A) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2018-12-27 |