| NPI | 1821217480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 001911-1) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: VT 145.0123982) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2018-03-17 |