| NPI | 1710909049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY KY-0334) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH 01147) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: KY 0770) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-19 |