| NPI | 1841236601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001728A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001728B) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2008-01-25 |