| NPI | 1457731358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: HI 18013) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: HI 18013) |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: HI 18013) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: HI 18013) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |