| NPI | 1629228580 |
|---|---|
| Former Name | KARLA RENEE CHEATHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MA 152528) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2008-09-26 |