| NPI | 1801053350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA AU542) |
| Additional Taxonomies | 231HA2400X Audiologist Assistive Technology Practitioner (Licence: CA HA1224) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |