| NPI | 1477682805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: HI AUD-88) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 80330) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-06-09 |