| NPI | 1376791186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD60098277) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: WA LD60098277) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2019-03-25 |