| NPI | 1164791091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: TX 80264) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: OK 996) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2020-06-03 |