| NPI | 1538687199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 021254) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NY 021254) |
| 363A00000X Physician Assistant (Licence: NY 021254) | |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 021254) | |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |