| NPI | 1568651669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 001898-1) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: NY 001898-1) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 001898-1) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2008-01-30 |