| NPI | 1467782896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 000343-1) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NY 14000022432) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2010-01-07 |