| NPI | 1326012865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO AUD272) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OR 30771) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2015-08-03 |