| NPI | 1255482469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 7151) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NC 1215) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2010-06-24 |