| NPI | 1912775289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NY C008718) |
| Additional Taxonomies | 156FC0800X Technician/Technologist, Contact Lens (Licence: NY C008718) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |