| NPI | 1073724712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A102563) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD33189) |
| 208600000X Surgery (Licence: WA 61138838) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MD D0066631) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2024-01-04 |