| NPI | 1720470651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: WA HA60511045) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: OR HAS-P-10130363) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |