| NPI | 1780741942 |
|---|---|
| Former Name | DARCIA M TIDEMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MN 9260) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: IL 147001331) |
| 231H00000X Audiologist (Licence: NE 214) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2022-04-11 |