| NPI | 1407935240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2440) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY981) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2023-09-12 |