| NPI | 1811556426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 12818174-4101) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TX 81038) |
| 231H00000X Audiologist (Licence: MO 2021003749) | |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2022-07-12 |