| NPI | 1457698953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002444) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 140000-40100) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2016-07-06 |