| NPI | 1932433257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 0585) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: IA 0822) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: IA 00585) | |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2014-01-09 |