| NPI | 1306271762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA A0004884) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA A0004884) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA A0004884) | |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX A0004884) | |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2025-11-28 |