| NPI | 1508904822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000013) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: MI 1601000013) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: MI 1601000013) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2019-10-31 |