| NPI | 1679661417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NV A107) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NV HAS211) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-09 |