| NPI | 1871915595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: OK 2474) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO R9E71) |
| 208D00000X General Practice (Licence: TX G8392) | |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |