| NPI | 1184044802 |
|---|---|
| Former Name | VICTORIA JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 66228) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2021-10-22 |