| NPI | 1417620329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MD 01618) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: PA AT006748) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2022-10-05 |