| NPI | 1215093083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA 3096) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: VA 2201001328) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-12-14 |