NPI | 1053795252 |
---|---|
Former Name | KAREN RENEE RILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: MI 16010000711) |
Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000711) |
Enumeration Date | 2015-07-17 |
Last Update Date | 2019-03-01 |