| NPI | 1184997918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY1779) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: FL AZ633) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2016-04-04 |