| NPI | 1598792798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT000722L) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: PA SL003794L) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2007-07-08 |