| NPI | 1619553047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CO HAD.0000499) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2023-04-14 |