| NPI | 1487048336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA 2973) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 80971) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2020-07-23 |