| NPI | 1740540681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD60987645) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 80359) |
| 231H00000X Audiologist (Licence: TX 80359) | |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2022-06-16 |