| NPI | 1316920499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002944A) |
| Additional Taxonomies | 152WL0500X Optometrist Low Vision Rehabilitation (Licence: IN 18002944A) |
| 152WS0006X Optometrist Sports Vision (Licence: IN 18002944A) | |
| 152WV0400X Optometrist Vision Therapy (Licence: IN 18002944A) | |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2021-06-07 |