| NPI | 1922071083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2811) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WI 500-156) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2024-08-20 |