| NPI | 1053609370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 8029647-4101) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: UT 8029647-4101) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2025-09-16 |