| NPI | 1699392381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD61240013) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NC 14278) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: WA LD61240013) | |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2023-04-19 |