| NPI | 1063628444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT000520L) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: PA AT000520L) |
| 237700000X Hearing Instrument Specialist (Licence: PA AT000520L) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-10-02 |