| NPI | 1114057411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: WA HA 60325844) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: OR HAS-P-1001628) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2013-10-21 |