| NPI | 1811596661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: DE O3-0000282) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 25MG00151800) |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |