NPI | 1487632329 |
---|---|
Former Name | LISA MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: WI 399156) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 1899154) |
Enumeration Date | 2005-12-31 |
Last Update Date | 2020-06-19 |