| NPI | 1790320992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: MS HA0656) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: LA 1300) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |