| NPI | 1003064163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MO 2008019308) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KS 1388) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2011-07-12 |