| NPI | 1588822019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NY 57-00201) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 41YA00077200) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00126600) | |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2014-06-11 |