| NPI | 1861826075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 10199354-4101) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: AK 131) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2020-04-30 |