| NPI | 1427199140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ YA000577) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NY 1552) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00090100) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-08-21 |