| NPI | 1407689060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: RI 403) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: MA 5657) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |