| NPI | 1043382120 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: GA 3855) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: GA 3588) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2009-08-13 |