| NPI | 1063531804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME122738) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX S8505) |
| 208600000X Surgery (Licence: LA 15759R) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MT MED-PHYS-LIC-117406) | |
| 282NC0060X General Acute Care Hospital, Critical Access (Licence: FL 122738) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: AZ 54029) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME122738) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S8505) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-09-11 |