| NPI | 1609177179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: MS HAD 0457) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: AL AL 4079) |
| 237700000X Hearing Instrument Specialist (Licence: LA 1080) | |
| Enumeration Date | 2010-11-15 |
| Last Update Date | 2010-11-15 |