| NPI | 1063814556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2355A2700X Specialist/Technologist, Audiology Assistant (Licence: CA 115107N) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: CA 115107) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |