| NPI | 1124616487 |
|---|---|
| Former Name | TARA RENEE KIVETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: NC 1635) |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NC 1178A01) |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2022-12-28 |