| NPI | 1467588624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MN 7314) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WI 430156) |
| 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: MN 7314) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: MN 7314) | |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2007-07-08 |