| NPI | 1245962257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 108607) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: IA 108607) |
| 237700000X Hearing Instrument Specialist (Licence: IA 115046) | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-09-22 |