| NPI | 1912698614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MD 01643) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MD 01643) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-06-20 |