| NPI | 1578859237 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX S2608) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2011016816) | 
| 207Y00000X Otolaryngology (Licence: FL ME135452) | |
| Enumeration Date | 2011-06-21 | 
| Last Update Date | 2019-07-05 |