| NPI | 1396372413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: NJ 25MG00155300) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist |
| 237700000X Hearing Instrument Specialist (Licence: NJ 25MG001553300) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-26 |