| NPI | 1174010276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter |
| 237700000X Hearing Instrument Specialist | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-03-15 |