| NPI | 1598930265 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: NC 12538) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: GA AUD003759) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2017-09-29 |