| NPI | 1174683429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY 66) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IN 23002093A) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2016-03-26 |