| NPI | 1316490386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WI 624) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: WI 624-156) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2018-11-30 |