| NPI | 1376227603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ZZ 46991) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: PA MD481443) |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-11-15 |