NPI | 1093790941 |
---|---|
Other Name | W JAMES FENNEWALD |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: OH SC2077) |
Additional Taxonomies | 156FC0801X Technician/Technologist, Contact Lens Fitter (Licence: OH SC2077) |
Enumeration Date | 2005-12-14 |
Last Update Date | 2019-01-28 |