| NPI | 1114561123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: LA 1302) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: MS HA0666) |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-11-01 |