| NPI | 1689437469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: OH 167081) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician (Licence: TX 167081) |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-02-05 |