| NPI | 1437143393 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: GA AUD003777) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: SC 3830) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: GA AUD003777) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-09-17 |