| NPI | 1699970384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist |
| Additional Taxonomies | 231H00000X Audiologist (Licence: ID AUD1484) |
| 231H00000X Audiologist (Licence: UT 6655994-4101) | |
| 332S00000X Hearing Aid Equipment | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2021-06-24 |