| NPI | 1689230997 |
|---|---|
| Former Name | JACLYN TOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: RI AUD00263) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: CA 3404) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2021-03-02 |