| NPI | 1104184258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CA AU484) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA AU484) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: CA AU484) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2018-03-29 |