| NPI | 1669762019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NY 286202) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2016-02363) |
| 207Y00000X Otolaryngology (Licence: NY 286202) | |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2018-06-29 |