| NPI | 1063531804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036163805) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: TX S8505) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: TX S8505) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2025-10-24 |