| NPI | 1124292057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NJ D3159) |
| Additional Taxonomies | 156FX1101X Technician/Technologist, Ophthalmic Assistant (Licence: NJ D3159) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |