| NPI | 1760755854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: TX 80278) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2018-03-17 |