| NPI | 1780066191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 80999) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA AU 3026) |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-12-20 |