| NPI | 1336249754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2571) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2005037433) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2023-02-01 |