| NPI | 1952518524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 50612) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 14067) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 90067) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |