| NPI | 1902164197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OH A01736) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: GA AUD003952) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2016-03-21 |