| NPI | 1770742637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 10322) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY1462) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NC 10322) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2016-11-06 |