| NPI | 1427361609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MI 3100) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NM 5501) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2015-08-10 |