| NPI | 1538757828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601001110) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2020032501) |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2024-11-19 |