| NPI | 1952564445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TN 1190) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 2133) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: TN 1190) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |