| NPI | 1043260060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: RI 189) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: MA 4475) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |