| NPI | 1376197236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 15407) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: SC 4124) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-07-13 |