| NPI | 1629321989 |
|---|---|
| Former Name | KELLY SUZANNE DVORAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: IL 147001438) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: IL 147001438) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2023-07-18 |