| NPI | 1477747376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: TX DR3992) |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens (Licence: TX DR3993) |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2021-12-16 |