| NPI | 1073152880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002922-01) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 002922-01) |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2023-05-17 |