| NPI | 1043355324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MO 2009001289) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IA 274) |
| 237700000X Hearing Instrument Specialist (Licence: IA 503) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2009-03-04 |