| NPI | 1689670077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OK 305) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 51685) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2023-09-07 |