| NPI | 1730521162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MA 4723) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CT 536) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: CT 536) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: MA 4723) | |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2018-08-29 |