NPI | 1174805972 |
---|---|
Former Name | KRISTINE ELLEN MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: CT 697) |
Additional Taxonomies | 231H00000X Audiologist (Licence: CO 637) |
Enumeration Date | 2011-09-16 |
Last Update Date | 2022-02-23 |