| NPI | 1417330499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MT SLP-AU-LIC-5874) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MT SLP-AU-LIC-5874) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-03-10 |