| NPI | 1518291731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: ID HA-1062) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: ID HA-1062) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2022-02-14 |