| NPI | 1699175307 |
|---|---|
| Former Name | DIANA RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MA 1068) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: RI AUD00214) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2020-07-30 |