| NPI | 1518974211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 80422) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IN 23002268A) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-10-07 |