| NPI | 1417102328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CO 204) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: TX 80249) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2010-08-03 |