| NPI | 1417118217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA5875) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: AZ DA5875) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2022-05-05 |