| NPI | 1164297115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA 002489) |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens (Licence: 002489) |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |