| NPI | 1013343235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TN 1705) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KY 1083) |
| 237700000X Hearing Instrument Specialist (Licence: TN 702) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2014-10-03 |