| NPI | 1639442023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WI 26-156) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: WI 26-156) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |