| NPI | 1467865816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: UT 10343236) |
| Additional Taxonomies | 231H00000X Audiologist |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-05-18 |