| NPI | 1053974485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101285470) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 92313) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-06-19 |