| NPI | 1982634606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003414A) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: IN 18003414A) |
| 152WV0400X Optometrist, Vision Therapy (Licence: IN 18003414A) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-05-15 |