| NPI | 1336697036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: NY 14000048378) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NY 57002689) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |