| NPI | 1437155108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: GA AUD000531) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY392) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: GA AUD000531) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2018-08-14 |