| NPI | 1093700999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AL 38-A) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: AL 38-A) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2011-12-01 |