| NPI | 1366889248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: PA FO3512) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: PA F03512) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2025-01-10 |