| NPI | 1083711063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD00001057) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: WA LD00001057) |
| 174400000X Specialist (Licence: WA LD00001057) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-06-25 |