| NPI | 1518052067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000568) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IL 147000875) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-11-13 |