| NPI | 1790292803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: OH 02967) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: OH 02967) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |