| NPI | 1457436735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MO 113808) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 113808) |
| 237700000X Hearing Instrument Specialist (Licence: MO 001241) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2014-02-06 |