| NPI | 1134876709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OR 31110) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WA LD61267028) |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2024-07-29 |