| NPI | 1205088150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: KY 44925) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN10480) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2012-03-23 |