| NPI | 1548473762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: CA SL2291) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-01-07 |