| NPI | 1255131231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: KY 158466) |
| Additional Taxonomies | 156FX1101X Technician/Technologist, Ophthalmic Assistant |
| 156FX1202X Technician/Technologist, Optometric Technician | |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |