| NPI | 1336661297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00097600) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00142400) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-07-21 |