| NPI | 1073521068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000377) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MI 3501004375) |
| 231H00000X Audiologist | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2023-11-08 |