| NPI | 1609125590 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO AUD.0000804) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2012026882) |
| 231H00000X Audiologist (Licence: FL AY2394) | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2025-02-04 |