NPI | 1104297449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601001048) |
Additional Taxonomies | 231H00000X Audiologist (Licence: VT 145.0116325) |
231H00000X Audiologist (Licence: CO AUD.0000941) | |
Enumeration Date | 2015-10-13 |
Last Update Date | 2024-02-28 |