| NPI | 1467943860 |
|---|---|
| Former Name | KATHERINE MAIRE RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IA 096122) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MI 1601000799) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2023-10-19 |