| NPI | 1326117847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002121) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000024556) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2008-06-06 |