| NPI | 1194049361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU00103902) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2018-12-20 |