| NPI | 1174977706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: OH 03003) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KY HISHSP00218693) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |