NPI | 1285865139 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003943A) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OH 5878) |
Enumeration Date | 2009-07-27 |
Last Update Date | 2016-09-13 |