| NPI | 1063038453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IN 23002773A) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000873) |
| 231H00000X Audiologist (Licence: OH A.02322) | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-03-14 |