| NPI | 1578163820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704306273) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4704306273) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2021-02-11 |