| NPI | 1902121437 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301107019) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD A-236-758-013-883) | 
| Enumeration Date | 2010-03-27 | 
| Last Update Date | 2021-12-03 |