| NPI | 1770825523 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL OS17526)  | 
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA OS018419)  | 
| Enumeration Date | 2013-03-20 | 
| Last Update Date | 2022-11-01 |