| NPI | 1891944245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: CO AUD.0000848) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000527) |
| 231H00000X Audiologist (Licence: GA AUD003813) | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2017-10-23 |