| NPI | 1104218353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: UT 10115233-4601) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CA HA 7922) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2016-10-18 |