| NPI | 1275863359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: RI 18) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: RI 95) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |