| NPI | 1508125063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MI 4301100481) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 269937) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2018-08-04 |