| NPI | 1548751589 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: GA AUD004130) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: GA AUD004130) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-08-14 |