| NPI | 1407296023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA9305) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CO 0000806) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2023-07-19 |