| NPI | 1205969318 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IL 147-000412) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: IL 147-000412) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: IL 147-000412) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-02-03 |