| NPI | 1609901024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: OR HASP119476) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OR 30205) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2025-09-11 |