| NPI | 1871056952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332S00000X Hearing Aid Equipment (Licence: KY 242066) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KY 242066) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 242066) | |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2019-08-03 |