| NPI | 1235687948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004070B) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN ODT3283) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2025-04-16 |