| NPI | 1407986938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 00155) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IA 00287) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |