| NPI | 1912196593 |
|---|---|
| Former Name | PURVIKA JITENDRA SHAH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00588000) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV0066731) |
| 152W00000X Optometrist (Licence: PA OEG001464) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |