| NPI | 1689115768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: VA 101048206) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202001577) |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |