| NPI | 1104213073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: GA 88656) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 88656) |
| Enumeration Date | 2015-04-18 |
| Last Update Date | 2022-07-11 |