| NPI | 1760862312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME145663) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN21993) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-08-04 |