| NPI | 1164660247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 51724) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 51724) |
| 231H00000X Audiologist (Licence: CO AUD-683) | |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2022-12-21 |