NPI | 1235649955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: MA 6100) |
Additional Taxonomies | 171W00000X Contractor (Licence: MA 6100) |
Enumeration Date | 2017-10-08 |
Last Update Date | 2017-10-08 |