| NPI | 1477701134 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT000242L) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 41Y00044800) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2019-11-20 |