| NPI | 1124775168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1900X Technician/Technologist, Orthoptist |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: TN DPO3507) |
| 156FX1800X Technician/Technologist, Optician (Licence: FL LDO7360) | |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |