| NPI | 1972750917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: MN 2637) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter |
| 237700000X Hearing Instrument Specialist (Licence: SD 314 H) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2018-03-17 |