| NPI | 1831412634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY 0332) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: KY 0760) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-05-04 |