| NPI | 1477217685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PR 1023) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PR 4120) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2024-05-09 |