| NPI | 1861493264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TN 1823) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: AL 1009a) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: FL AY1120) | |
| 231H00000X Audiologist (Licence: FL AY1120) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-03-31 |