| NPI | 1891762407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KS 1843) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2019016856) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-10-06 |