| NPI | 1811447741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NJ 41YA00124800) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TN 1740) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2023-06-08 |