| NPI | 1699469627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: MA 6862) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: VT 028.0133171) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |