| NPI | 1508978230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002408A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002408B) |
| 152W00000X Optometrist (Licence: IN 18002408) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-03-21 |