| NPI | 1972050854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: KY 100738) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KY 141393) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |