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 |