| NPI | 1003184433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 10128) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: PA AT006132) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2012-09-05 |