| NPI | 1093773152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY37) |
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL AY37) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2015-08-04 |