| NPI | 1679870299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00078800) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 25MG00121500) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2022-03-02 |