| NPI | 1245546928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: OR 030789) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WA AI60153765) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2021-06-11 |