| NPI | 1669812194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NY 002473) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NY 00273) |
| 231H00000X Audiologist (Licence: NJ 41YA00134900) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000038555) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2026-08-21 |