| NPI | 1174651947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YB00001100) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: FL AY1670) |
| 231H00000X Audiologist (Licence: NY 000770-01) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-05-27 |