| NPI | 1487489654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 13975229-4101) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: UT 13975229-4101) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2026-01-22 |