| NPI | 1912952011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NJ 25MG00042100) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 31TD00038900) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-04-29 |