| NPI | 1689158222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT006612) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A.02156) |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-12-26 |