| NPI | 1639548910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MO 2015039572) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 80810) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2025-08-27 |