| NPI | 1679720957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 5019) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NC 1032) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2009-09-15 |