| NPI | 1023066024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD60575483) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35082313w) | 
| Enumeration Date | 2006-05-04 | 
| Last Update Date | 2016-03-08 |