| NPI | 1033396288 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: OR 021744) | 
| Additional Taxonomies | 231H00000X Audiologist (Licence: OR 021744) | 
| 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: OR 021744) | |
| 231HA2500X Audiologist, Assistive Technology Supplier (Licence: OR 021744) | |
| 237700000X Hearing Instrument Specialist (Licence: OR 476779) | |
| Enumeration Date | 2008-01-29 | 
| Last Update Date | 2010-11-02 |