| NPI | 1649568957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 8092096-4101) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: UT 8092096-4101) |
| 235500000X Specialist/Technologist (Licence: UT 8092096-4101) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: UT 8092096-4101) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2013-05-14 |