| NPI | 1588000954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ME MD22118) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301102606) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2018-08-03 |