| NPI | 1851542773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NJ 31TD00104000) |
| Additional Taxonomies | 332S00000X Hearing Aid Equipment (Licence: NJ MG60000689) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |