| NPI | 1982367355 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: MI 1601001179) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: UT 124842724101) |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2025-01-21 |