| NPI | 1184076465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: ID AUD2936) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: ID AUD-2936) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2026-03-05 |