NPI | 1770596363 |
---|---|
Former Name | SUSAN D GIBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: MO 2002027720) |
Additional Taxonomies | 231H00000X Audiologist (Licence: KS 1239) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2022-07-21 |