| NPI | 1386318129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NY 005757) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-08-05 |