| NPI | 1457891509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2135) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AZ 725) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2018-06-14 |