| NPI | 1760721609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 12587) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: SC 4075) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2021-04-27 |