| NPI | 1881698298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: PA AT000017L) |
| Additional Taxonomies | 231HA2500X Audiologist, Assistive Technology Supplier (Licence: PA AT000017L) |
| 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: PA AT000017L) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: PA AT000017L) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2015-02-03 |