NPI | 1194357624 |
---|---|
Former Name | TAYLOR JUDITH PROSKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: MO 2021020504) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-02-12 |
Last Update Date | 2021-06-07 |