| NPI | 1801280789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MT Med-PHYS-LIC-99948) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MT Med-PHYS-LIC-99948) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A144385) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2023-07-04 |