| 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 |