| NPI | 1588181648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO 869) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: FL AY2322) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2026-06-08 |