| NPI | 1043573652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA FW7702966) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PA MT212587) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301101298) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2020-08-27 |