| NPI | 1306029731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: KY 0474) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY107) |
| 237700000X Hearing Instrument Specialist (Licence: KY KY207) | |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |