| NPI | 1770927642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME139719) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101264446) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2019-08-26 |