| NPI | 1417292590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2915) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: AZ DA13549) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2025-12-02 |