| NPI | 1285654152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000166) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-07-21 |