| NPI | 1649445636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00057100) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 41YA00057100) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-09-08 |