| NPI | 1760909121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2171) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: FL AY2171) |
| Enumeration Date | 2017-08-27 |
| Last Update Date | 2022-07-21 |