| NPI | 1538641931 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 81056)  | 
| Additional Taxonomies | 231H00000X Audiologist (Licence: AZ DA13584)  | 
| 231H00000X Audiologist (Licence: CO AUD.00000976)  | |
| 231H00000X Audiologist (Licence: OK 5958)  | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NM AUD6780)  | |
| 237700000X Hearing Instrument Specialist (Licence: TX 80807)  | |
| Enumeration Date | 2018-08-31 | 
| Last Update Date | 2024-05-24 |