| NPI | 1659105146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 003294) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NC 300001351) |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2025-05-30 |