| NPI | 1750856910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA11507) |
| Additional Taxonomies | 231H00000X Audiologist |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: AZ DA11507) | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2025-07-01 |