| NPI | 1225085673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MA 556) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY753) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-12-01 |