| NPI | 1336880046 |
|---|---|
| Former Name | SOPHIA MARIE COLEVAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 82848-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-12-06 |