| NPI | 1649592346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO AUD.0000847) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A01505) |
| 231H00000X Audiologist (Licence: IN 23002273A) | |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2018-03-17 |