| NPI | 1467829721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AK 135356) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: ND 1453) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2018-12-17 |