| NPI | 1164844544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: WY 186) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CO 232) |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2021-03-24 |