| NPI | 1629399985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME125928) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-058029) |
| 207Y00000X Otolaryngology (Licence: GA 4854) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2019-05-06 |