| NPI | 1861049629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY 247998) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A.02221) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-08-26 |