| NPI | 1528386471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: TX 216467) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 36772) |
| Enumeration Date | 2010-05-16 |
| Last Update Date | 2016-01-21 |