| NPI | 1780734079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NE 171) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NE 171) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2010-11-22 |