| NPI | 1699783779 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: KS 640) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: KS 771) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2012-11-20 |