| NPI | 1073037495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OR 31036) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WA LD61019728) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WA LD61019728) | |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2024-05-17 |