| NPI | 1780846279 |
|---|---|
| Former Name | AMY SHANNON KETCHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U2076) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A123578) |
| 207Y00000X Otolaryngology (Licence: PA MD457154) | |
| 207Y00000X Otolaryngology (Licence: WV 28326) | |
| 207Y00000X Otolaryngology (Licence: MN 68440) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2023-09-03 |