| NPI | 1356393706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 519) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: IA 913) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-12-28 |