| NPI | 1861819401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: IL 3295) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: IL 038.012589) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2020-11-16 |