| NPI | 1316006620 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001679A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001679B) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2014-09-03 |