| NPI | 1811231152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 50565644101) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 80538) |
| 237700000X Hearing Instrument Specialist (Licence: UT 50565644601) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2022-07-21 |