| NPI | 1558754929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: OH 10984) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: WV 1040) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-03-25 |