| NPI | 1689943854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 9794) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NC 9794) |
| Enumeration Date | 2011-12-17 |
| Last Update Date | 2011-12-22 |