| NPI | 1992080550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CA HA6031) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CO HAD0000247) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2015-07-17 |