| NPI | 1851700546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KS 2261) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2019023951) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2022-10-06 |