| NPI | 1790405686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 81580) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A.02410) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2023-04-20 |