| NPI | 1215089073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: IL 0417) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: WI 426-060) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-09 |