| NPI | 1710121975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 26753) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 37158) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2021-01-08 |