| NPI | 1114171840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NH A555) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MA SP891AU) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2011-06-03 |