| NPI | 1063617157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 57573) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 50924) |
| 207L00000X Anesthesiology (Licence: WI 57573) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2014-03-07 |