| NPI | 1306378716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: VA 0101275623) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA 306426) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-01-06 |