| NPI | 1649623737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL 1929) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MA SP-1087-AU) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |