| NPI | 1225148604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL000187L) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP2191) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: PA AT000076L) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: PA F02191) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |