| NPI | 1992799688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: UT 365734101) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NV A-134) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2025-11-12 |