| NPI | 1932160728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3554) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 6609TG) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-11-12 |