| NPI | 1336178821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 1149) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 846) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-07-21 |