NPI | 1639422470 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MT MED-PAC-LIC-19990) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-19990) |
Enumeration Date | 2012-10-17 |
Last Update Date | 2025-03-18 |