| NPI | 1851431084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: SC 3903) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NV A-191) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2011-12-05 |