| NPI | 1255577623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00104500) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: PA AT006104) |
| 231H00000X Audiologist (Licence: NJ 41YA00077000) | |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2012-06-06 |