| NPI | 1205435237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY 282796) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: OH A.02272) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2023-01-25 |