| NPI | 1629448998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2813) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NC 11652) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2024-07-23 |