| NPI | 1457090078 |
|---|---|
| Former Name | TAYLOR DIECKMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601001140) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IL 147001907) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2024-04-23 |