| NPI | 1255610648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME130483) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.122974) |
| 207Y00000X Otolaryngology (Licence: IA R-9101) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2022-07-21 |