| NPI | 1942307053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18002644) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TN T1494) |
| 152W00000X Optometrist (Licence: IL 46008622) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-11-13 |