| NPI | 1356400881 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CT 000072) |
| Additional Taxonomies | 231HA2500X Audiologist, Assistive Technology Supplier (Licence: CT 000072) |
| 332S00000X Hearing Aid Equipment (Licence: CT 000072) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |