| NPI | 1063646495 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DC MD042204)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2009-05-13 | 
| Last Update Date | 2014-06-24 |