| NPI | 1992181374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA9104) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: AZ DA9104) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: AZ DA9104) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2015-08-07 |