| NPI | 1659789501 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 80678) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: TX 80678) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2018-01-25 |