| NPI | 1639107956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OR 22387) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: OR HAS-P-051619) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2010-03-29 |