| NPI | 1679233340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: PA F02804) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NY 14000002597) |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2021-12-22 |