| NPI | 1154352656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: VA 2101 000560) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: VA 2201000440) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-09-29 |