| NPI | 1871679787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 4971390-4101) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: UT 4971390-4101) |
| 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: CA AU2231) | |
| 231H00000X Audiologist (Licence: CA AU2231) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2021-01-27 |