| NPI | 1124149315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CA 7721) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: MO 2005030823) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2012-06-29 |