| NPI | 1508951187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: WY A-937) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WY A-937) |
| 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: WY A-937) | |
| 231HA2500X Audiologist, Assistive Technology Supplier (Licence: WY A-937) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WY A-937) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-09-11 |