| NPI | 1689024986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO 843) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OR 030856) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2018-09-20 |