| NPI | 1063987139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA AU4054) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2025-07-31 |