| NPI | 1730112442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X (Licence: AZ 25752) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2005-00845) |
| 207YS0012X (Licence: VA 0101280540) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2024-01-23 |