| NPI | 1750432373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000203) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: MI 3501001250) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-09 |