| NPI | 1578863700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: WA HA 00004733) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: OR HAS-P-509154) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2010-10-21 |