| NPI | 1861412447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: OR 22952) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OR 22952) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2013-04-23 |