| NPI | 1821053679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 51683) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 51683) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2022-01-25 |