| NPI | 1295098960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KS 2287) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2012017267) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2015-07-22 |