| NPI | 1750535373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000343) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: MI 1601000342) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: MI 1601000343) | |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2008-11-10 |