| NPI | 1194823054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA 3208) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WA LD60042114) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WA LD60042114) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-07-12 |