| NPI | 1962638502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: SC 38475) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: PA MT195945) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2015-09-14 |