| NPI | 1962682203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ da6557) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: CA 3283) |
| Enumeration Date | 2007-11-04 |
| Last Update Date | 2025-03-20 |