NPI | 1164869277 |
---|---|
Former Name | AMANDA D BOUTILIER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: ND 1262) |
Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: ND H-0318) |
Enumeration Date | 2013-05-30 |
Last Update Date | 2022-02-01 |