| NPI | 1619309036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000044506) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NY 002480-1) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2017-04-14 |