| NPI | 1962515791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 2701) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18002701B) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2015-08-27 |