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 |