| NPI | 1487002689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA 3334) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: UT 9806481-4101) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2022-02-11 |