| NPI | 1407144330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: CA 6462) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: CA 7602) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2011-08-19 |