| NPI | 1851519995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OH OA00166) |
| Additional Taxonomies | 231HA2400X Audiologist Assistive Technology Practitioner |
| 231HA2500X Audiologist Assistive Technology Supplier | |
| 237700000X Hearing Instrument Specialist | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-07-08 |