| NPI | 1235460429 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 237600000X Audiologist-Hearing Aid Fitter (Licence: MO 2013041035) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: KS 2185) |
| 231H00000X Audiologist (Licence: KS 2185) | |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2014-07-28 |