| NPI | 1407846645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 152WC0802X Optometrist Corneal and Contact Management (Licence: IN 18001595B) |
| Additional Taxonomies | 152WP0200X Optometrist Pediatrics (Licence: IN 18001595B) |
| 152WS0006X Optometrist Sports Vision (Licence: IN 18001595B) | |
| 152WX0102X Optometrist Occupational Vision (Licence: IN 18001595B) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2007-07-09 |