| NPI | 1356313472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001937B) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18001937B) |
| 152WX0102X Optometrist, Occupational Vision (Licence: IN 18001937B) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2017-01-25 |