| NPI | 1952425415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MO 108364) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NE 175) |
| 237700000X Hearing Instrument Specialist (Licence: MO 1047) | |
| 237700000X Hearing Instrument Specialist (Licence: NE 644) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2015-12-16 |