| NPI | 1124293394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: ME AP4240) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MA 8142) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2025-02-25 |