| NPI | 1649516931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: CO 0000259) |
| Additional Taxonomies | 235500000X Specialist/Technologist (Licence: CO 0000259) |
| 2355A2700X Specialist/Technologist Audiology Assistant (Licence: CO 0000259) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: CO 0000259) | |
| 237700000X Hearing Instrument Specialist (Licence: CO 200588) | |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2019-12-06 |