| NPI | 1932460615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CA HA2996) |
| Additional Taxonomies | 156F00000X Technician/Technologist (Licence: CA SL4692) |
| 156FX1800X Technician/Technologist, Optician (Licence: CA SL4692) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-12-06 |