| NPI | 1093103681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU3272) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 17275) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: CA HA8060) | |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2018-06-03 |