| NPI | 1104297506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 313770) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: PA MD455706) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2022-06-27 |