NPI | 1538317839 |
---|---|
Former Name | KATHERINE MARIE WAGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601000523) |
Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MI 1601000523) |
Enumeration Date | 2008-08-29 |
Last Update Date | 2008-11-21 |