| NPI | 1821504143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: VA 2101000640) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: MD 02619) |
| 237700000X Hearing Instrument Specialist (Licence: WV 583) | |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2018-03-17 |