| NPI | 1912165200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: NY 14000025676) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 25MG0001091001) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2023-02-14 |