| NPI | 1295829141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY1534) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A01585) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2016-11-29 |