| NPI | 1083177562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: NM HAD0898) |
| Additional Taxonomies | 261QH0700X Clinic/Center Hearing and Speech (Licence: NM HAD0898) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2022-01-03 |