| NPI | 1164586939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: UT 113139-4101) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: OR 21465) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-02-22 |