| NPI | 1831539915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD61158244) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A.01857) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2021-08-20 |