| NPI | 1669739785 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME154826)  | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD460921)  | 
| 207Y00000X Otolaryngology (Licence: LA 308860)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-13 | 
| Last Update Date | 2022-03-02 |