| NPI | 1942295282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18001973A) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18001973) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2022-04-04 |