NPI | 1093050692 |
---|---|
Former Name | LIZA M BUTTON BONNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: VA 2201001240) |
Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: VA 2101001668) |
237600000X Audiologist-Hearing Aid Fitter (Licence: VA 2101001668) | |
Enumeration Date | 2012-12-07 |
Last Update Date | 2012-12-07 |