| NPI | 1053557157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 000382) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 002705) |
| Enumeration Date | 2008-12-20 |
| Last Update Date | 2008-12-31 |