| NPI | 1356655856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003700A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.010372) |
| 152W00000X Optometrist (Licence: CA OPT13946TLG) | |
| 152W00000X Optometrist (Licence: IN 18003700B) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2014-03-18 |