| NPI | 1841069655 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA LDO002986) | 
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens (Licence: GA LDO002986) | 
| 156FC0801X Technician/Technologist, Contact Lens Fitter (Licence: GA LDO002986) | |
| 156FX1800X Technician/Technologist, Optician (Licence: GA ABO-NCLE234728) | |
| Enumeration Date | 2023-12-21 | 
| Last Update Date | 2023-12-27 |