| NPI | 1891878906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WY A-951) |
| Additional Taxonomies | 231H00000X Audiologist |
| 237600000X Audiologist-Hearing Aid Fitter | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2021-09-20 |