| NPI | 1427304880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PR 604) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PR 932) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2013-03-19 |