| NPI | 1316050404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 2456) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CA 7620) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2012-10-16 |