| NPI | 1285717603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001681A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001681b) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2008-01-17 |