| NPI | 1629865357 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KS 2532) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MO 2025035831) |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2026-05-26 |