| NPI | 1861867467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9109217) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL 9109217) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2020-12-02 |