| NPI | 1518163260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NJ 0003321) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 00987) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2009-08-27 |