| NPI | 1558534586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201001356) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: VA 2101001681) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2013-01-02 |