| NPI | 1851256556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO 0001345) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CO AUD.0001345) |
| Enumeration Date | 2025-12-16 |
| Last Update Date | 2026-06-04 |