| NPI | 1922888775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 156FX1101X Technician/Technologist, Ophthalmic Assistant |
| 156FX1100X Technician/Technologist, Ophthalmic | |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-09-29 |