| NPI | 1902851470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 231HA2400X Audiologist Assistive Technology Practitioner (Licence: NJ 25MG00040300) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 25MG00040300) |
| 237700000X Hearing Instrument Specialist (Licence: NJ 41YA00010300) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-05-18 |