| NPI | 1669512208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU2077) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CA HA2679) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |