| NPI | 1215026497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NM 97-130) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM 97-130) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-12-04 |