| NPI | 1689960312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY 167959) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TN 1921) |
| 237700000X Hearing Instrument Specialist (Licence: KY 168581) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-02-04 |