NPI | 1962045310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
Enumeration Date | 2019-10-17 |
Last Update Date | 2019-10-17 |