NPI | 1871590430 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003429 A & B) |
Additional Taxonomies | 152W00000X Optometrist (Licence: VA 0601800582) |
Enumeration Date | 2005-06-28 |
Last Update Date | 2007-07-08 |