| NPI | 1407021322 |
|---|---|
| Other Name | NA NA NA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NJ d-755) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NJ d755) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |