| NPI | 1790780948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25MG00067800) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 41YA00032200) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2024-01-15 |