| NPI | 1417939273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002194B) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18002194B) |
| 152WS0006X Optometrist, Sports Vision (Licence: IN 18002194B) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2018-08-15 |