| NPI | 1952518524 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 90067)  | 
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 50612)  | 
| 235Z00000X Speech-Language Pathologist,   (Licence: TX 14067)  | |
| Enumeration Date | 2007-05-16 | 
| Last Update Date | 2025-09-11 |