| NPI | 1124057468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NY 003234) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NY 14000006712) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2007-07-09 |