| NPI | 1326703463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201001854) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OK 5583) |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2023-01-13 |