| NPI | 1760427413 | 
|---|---|
| Professional Name | G. GAVIN GERONDALE | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 3469TG) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX 03469tg) | 
| Enumeration Date | 2006-06-17 | 
| Last Update Date | 2016-05-27 |