| NPI | 1316197726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AUDIOLOGY5099)  | 
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA ht8404)  | 
| Enumeration Date | 2008-09-22 | 
| Last Update Date | 2008-09-22 |