| NPI | 1598380404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MD 01652) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CO AUD.0001020) |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2024-04-04 |