| NPI | 1336583616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CO 48) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: WY 109) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2013-04-17 |