| NPI | 1891144911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME148287) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 267039) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2022-09-21 |