| NPI | 1588792097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301089143) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD426319) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MI 4301089143) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-08-31 |