| NPI | 1073726469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME132261) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 056774) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: GA 056774) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-12-01 |