| NPI | 1679819122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: UT 7390246-4601) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: UT 7390246-4101) |
| Enumeration Date | 2013-01-02 |
| Last Update Date | 2022-08-25 |