| NPI | 1518091495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 797) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NC 599) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2011-11-15 |