| NPI | 1730918004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD61596842) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: WA LD61596842) |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2025-10-06 |