| NPI | 1184818692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: TX 80495) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CA 7275) |
| 237700000X Hearing Instrument Specialist (Licence: NM 0630) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2015-07-20 |