| NPI | 1841240975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201001330) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: VA 2101001673) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2016-03-18 |