| NPI | 1134256035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 1128) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NC 1128) |
| 237700000X Hearing Instrument Specialist (Licence: NC 1128) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2017-03-17 |