| NPI | 1801192141 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: GA HADS000792) | 
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter | 
| Enumeration Date | 2011-02-03 | 
| Last Update Date | 2022-04-12 |