| NPI | 1518148600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU 281) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA HA 3828) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2012-12-13 |