| NPI | 1023051588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU651) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA AU651) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-08-14 |