| 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 |