| NPI | 1730128844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001702B) |
| Additional Taxonomies | 152WV0400X Optometrist, Vision Therapy (Licence: IN 18001702b) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2018-12-04 |