| NPI | 1164507372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231HA2500X Audiologist, Assistive Technology Supplier (Licence: CA HA973) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA AU665) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2013-07-17 |