NPI | 1699896027 |
---|---|
Former Name | TRACEY LIAKOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AZ 6517) |
Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IL 036.124716) |
Enumeration Date | 2007-04-03 |
Last Update Date | 2021-06-18 |