| NPI | 1700258019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MT 5221) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MT 5221) |
| 237700000X Hearing Instrument Specialist (Licence: MT 5221) | |
| 332S00000X Hearing Aid Equipment (Licence: MT 5221) | |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2016-05-23 |