| NPI | 1689237026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CT 83133) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 92997) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-11-06 |