| NPI | 1316974702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: ID AU-1069) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA AU-1961) |
| 231H00000X Audiologist (Licence: PA AT-000813-L) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2012-10-19 |