| NPI | 1326827007 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 231H00000X Audiologist (Licence: CT 752) | 
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: CT 752) | 
| 235500000X Specialist/Technologist (Licence: CT 752) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: CT 000752) | |
| 237700000X Hearing Instrument Specialist (Licence: CT 752) | |
| Enumeration Date | 2023-09-22 | 
| Last Update Date | 2024-03-18 |