| NPI | 1225423601 |
|---|---|
| Former Name | MIRANDA DENISE COLLETTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 86510) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 86199) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2022-09-02 |