NPI | 1730227349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: VA 1101001434) |
Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NC 1129) |
Enumeration Date | 2007-02-03 |
Last Update Date | 2007-11-26 |