| NPI | 1558556753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA000076) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00049600) |
| 231H00000X Audiologist (Licence: NY 0007561) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 41YA00007600) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2019-06-28 |