| NPI | 1841059607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: AZ LDO-003279) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: FL DO7743) |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-03-15 |