| NPI | 1528232089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KS 2152) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2015029992) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2022-02-23 |