| NPI | 1275230708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: OH op.2291sc) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: OH 2291SC) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |