| NPI | 1801307392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: ID Aud-6072) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NV A-2045) |
| 231H00000X Audiologist (Licence: MT SLP-AU-LIC-11601) | |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2023-12-27 |