| NPI | 1679003420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004023A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18004023) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-05-13 |