| NPI | 1053748475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU3261) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: PA AT006315) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2018-03-21 |