| NPI | 1346521655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO AUD.0000627) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CO 627) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2024-01-25 |