| NPI | 1700938446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MO 2001005486) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2001005486) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2012-10-22 |