| NPI | 1164639936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 50530) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: TX 50530) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-02-24 |