| NPI | 1073877619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MO 2015043959) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2015043959) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2022-07-21 |