NPI | 1194858654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT000421L) |
Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 25MG00057900) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2020-08-10 |