| NPI | 1912011727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002348B) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002348) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2018-12-20 |