| NPI | 1467498725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MN 5567) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WI 49-156) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: MN 5567) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-11-20 |