NPI | 1679878979 |
---|---|
Former Name | JANICE RIVERA TANEDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY2286) |
Additional Taxonomies | 231H00000X Audiologist (Licence: MA 939) |
Enumeration Date | 2011-01-18 |
Last Update Date | 2019-07-22 |