NPI | 1700011657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: MA 1594) |
Additional Taxonomies | 156FC0801X Technician/Technologist Contact Lens Fitter (Licence: MA 1594) |
Enumeration Date | 2009-05-21 |
Last Update Date | 2009-05-21 |