| NPI | 1063651834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 170) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IL 147-000009) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-02-18 |