| NPI | 1821614306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AL 1320A) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NM AUD7054) |
| 231H00000X Audiologist (Licence: MS AUD4689) | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-01-27 |