| NPI | 1811418296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00097300) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner |
| 231HA2500X Audiologist, Assistive Technology Supplier | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2022-07-21 |