| NPI | 1902884836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: LA 785) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: LA 785) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2023-10-26 |