| NPI | 1285630046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OH A.02301) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000339) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-05-10 |