| NPI | 1043604986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MT218583) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.067657) |
| 208600000X Surgery (Licence: CA A159753) | |
| 208600000X Surgery (Licence: NY P08307) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2021-08-16 |