| NPI | 1508419771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002865) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000057896) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 15000057896) | |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2022-02-09 |