| NPI | 1366744427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: PR #416) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: PR 416) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2010-11-23 |