| NPI | 1205247772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: SC 4013) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: SC 4013) |
| 231H00000X Audiologist (Licence: OH A01894) | |
| Enumeration Date | 2014-05-18 |
| Last Update Date | 2022-07-06 |