| NPI | 1265729693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003681A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003681B) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2014-06-30 |