| NPI | 1447340377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT000199L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA AT000199L) |
| 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: PA AT000199L) | |
| 231HA2500X Audiologist, Assistive Technology Supplier (Licence: PA AT000199L) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: PA AT000199L) | |
| 332S00000X Hearing Aid Equipment (Licence: PA AT000199L) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-01-15 |