| NPI | 1821219197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 6716) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NC 1211) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-06-17 |