| NPI | 1093743858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 51369) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 51369) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2010-08-16 |