| NPI | 1154475655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CT 000075) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CT 000103) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-05 |