| NPI | 1689762395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 231HA2400X Audiologist Assistive Technology Practitioner |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: MI 1601000185) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2008-05-20 |