| NPI | 1790198950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: OH 03072) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH 00238) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |