| NPI | 1780600536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: MA 5612) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NH 568) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |