| NPI | 1639543234 |
|---|---|
| Former Name | TARA JEAN UNDERKOFLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AL 1121a) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: GA AUD003761) |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: AL 1121a) | |
| 237600000X Audiologist-Hearing Aid Fitter (Licence: GA AUD003761) | |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2017-10-12 |