NPI | 1063778363 |
---|---|
Former Name | CARLY JIGANTI STEWART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 22377) |
Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A149372) |
207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NH 22377) | |
Enumeration Date | 2012-04-11 |
Last Update Date | 2022-02-24 |