| NPI | 1023506821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TN 1962) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 80959) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2024-01-18 |