| NPI | 1245756253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MT 6662) |
| 332S00000X Hearing Aid Equipment (Licence: MT 6662) | |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2024-05-14 |