| NPI | 1003632506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: PR 830) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: PR 0830) |
| 156FX1900X Technician/Technologist Orthoptist | |
| Enumeration Date | 2024-11-29 |
| Last Update Date | 2024-11-29 |