| NPI | 1811631195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201001877) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: VA 2101002525) |
| Enumeration Date | 2022-04-23 |
| Last Update Date | 2024-10-28 |