| NPI | 1649720251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: DE O2-0000118) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: PA AT001141L) |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-10-06 |