| NPI | 1629251616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2203) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2018-10-17 |