| NPI | 1710736863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OH A.02512) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: KY 295446) |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2025-12-19 |