| NPI | 1518242445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY 173946) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: KY 174221) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2022-07-21 |