| NPI | 1629496211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 80694) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: IA MD-49746) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2025-09-16 |