| NPI | 1932357290 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KY KY-0364) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |