| NPI | 1174134571 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002966) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 1340077) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2023-12-08 |