| NPI | 1821194887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MD 00100) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: PA AT000087L) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-12-06 |