| NPI | 1730606955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AZ DA11508) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA 11509) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2021-10-06 |