| NPI | 1750398244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA4871) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: AZ DA4871) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2022-03-03 |