| NPI | 1801031299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OK 32) |
| Additional Taxonomies | 231HA2500X Audiologist, Assistive Technology Supplier (Licence: OK 32) |
| Enumeration Date | 2008-12-13 |
| Last Update Date | 2008-12-13 |