| NPI | 1336395367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002227) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000026917) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2012-11-01 |