| NPI | 1548758865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004111A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18004111B) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2023-05-11 |