| NPI | 1366537987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO 10) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CO 10) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-10-17 |