| NPI | 1003234568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: OK 38258) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT205926) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2021-06-22 |