| NPI | 1407280324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2444) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NE 405) |
| 231H00000X Audiologist (Licence: IA 000762) | |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2021-08-30 |