| NPI | 1093408262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA 3850) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CT 743) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2023-10-27 |