| NPI | 1568595890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231HA2500X Audiologist, Assistive Technology Supplier (Licence: OK 94) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 94) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-05-02 |