| NPI | 1093762692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA CD000025516) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: WA CD00002516) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2018-03-07 |