| NPI | 1922038397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201000161) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV (WVDE) 2173) |
| 235Z00000X Speech-Language Pathologist, (Licence: VA 2202002014) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WV A-0204) | |
| 237700000X Hearing Instrument Specialist (Licence: VA 2101000348) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-19 |