| NPI | 1295894855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MO 2023003296) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 51759) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-02-03 |