| NPI | 1841482783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 53392) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN student status) | 
| Enumeration Date | 2007-08-14 | 
| Last Update Date | 2021-06-08 |