NPI | 1144616202 |
---|---|
Former Name | KIVONEY WISDOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 237700000X Hearing Instrument Specialist (Licence: DE O3-0010283) |
Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: NJ 25MG00110700) |
237700000X Hearing Instrument Specialist (Licence: PA F03257) | |
Enumeration Date | 2015-04-15 |
Last Update Date | 2022-03-29 |