| NPI | 1548863558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: DC AUD000246) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: DC AT006692) |
| 231H00000X Audiologist (Licence: PA AT006692) | |
| 231H00000X Audiologist (Licence: MD 01540) | |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2021-03-26 |