| NPI | 1427093475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MN 6443) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WI 332156) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-05-31 |