| NPI | 1346265741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OR 21527) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: OR 975241) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-05-12 |