| NPI | 1689297228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 115615) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: WA AUD.LD.61069669) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WA AUD.LD.61069669) | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2022-08-18 |