| NPI | 1992763320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: SD 355A) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WI 427-156) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2009-02-19 |