| NPI | 1700158631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: MO 2012011481) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KS 1567) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2016-05-11 |