| NPI | 1346595949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA 2842) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MN 9587) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2016-04-27 |