| NPI | 1821440074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 14000048561) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 41YA00092800) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2017-11-30 |