| NPI | 1043826969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: VA 2101002458) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: VA B201502220) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-17 |