| NPI | 1033112651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 13858) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY692) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2020-08-07 |