| NPI | 1619149275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00003200) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 25MG0081700) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |