| NPI | 1972508679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 51191) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 51191) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2018-05-24 |