| NPI | 1942613831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 32835) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 59396) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301105915) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2020-08-25 |