| NPI | 1316543473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NE 454) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2020040100) |
| 231H00000X Audiologist (Licence: KS 2402) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: KS 1827) | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2026-04-09 |