| NPI | 1912247685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ 25mg00126500) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NJ 41YA00079600) |
| 237700000X Hearing Instrument Specialist (Licence: NJ 25MG00126500) | |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2019-11-12 |