NPI | 1912490665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004106A) |
Additional Taxonomies | 152W00000X Optometrist (Licence: IN 1800) |
Enumeration Date | 2018-06-07 |
Last Update Date | 2022-04-04 |