| NPI | 1871871970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: FL AS5821) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: PA F03596) |
| 164W00000X Licensed Practical Nurse (Licence: PR PN287575) | |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2024-08-27 |