NPI | 1649601394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: FL DO6032) |
Additional Taxonomies | 156FC0801X Technician/Technologist, Contact Lens Fitter (Licence: FL DO6032) |
Enumeration Date | 2013-12-06 |
Last Update Date | 2024-06-17 |