| NPI | 1366069296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 81585) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY2376) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2023-09-07 |