| NPI | 1891298162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2355A2700X Specialist/Technologist, Audiology Assistant |
| Additional Taxonomies | 156FX1201X Technician/Technologist, Optometric Assistant |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |