| NPI | 1497916936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT006163) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL az538) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2017-01-12 |