NPI | 1629331509 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: NY 323003) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-06-16 |
Last Update Date | 2023-09-19 |