| NPI | 1841698776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231HA2500X Audiologist, Assistive Technology Supplier (Licence: KY 170797) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: KY 170797) |
| 231H00000X Audiologist (Licence: IN 17001431A) | |
| 237700000X Hearing Instrument Specialist (Licence: KY 170797) | |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2018-12-12 |