| NPI | 1750333084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT005853) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: OH A01527) |
| 231H00000X Audiologist (Licence: OK 346) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-05-12 |