| NPI | 1477745479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: SD 1085-A) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WA LD00004653) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-10-04 |