| NPI | 1609112911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: GA HADS000813) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: SC HAD-0468) |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2012-12-14 |