| NPI | 1689711665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002513A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002513) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-01-28 |