| NPI | 1467510529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: OR 30764) |
| Additional Taxonomies | 231HA2400X Audiologist, Assistive Technology Practitioner (Licence: OR 30764) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: OR 30764) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2013-04-29 |