| NPI | 1366779621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00076800) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: PA AT006127) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2009-11-06 |