| NPI | 1477682714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000300) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: MI 3501002046) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2007-07-09 |