| NPI | 1205156155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IN 23002473A) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A. 01732) |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2012-02-20 |