| NPI | 1144750910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OH A02067) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: GA AUD004100) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2018-08-10 |