| NPI | 1760602619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: SC HAS-0581) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: FL AS4002) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2018-06-11 |