| NPI | 1962638619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: TX 80299) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 80299) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2019-02-20 |